In children under 5-yrs-old with resp: distress, preference is nasal cannula

If severe hypoxaemia persists despite maximal flow rates:

• start CPAP (if available)
• start secondary source of oxygen with face mask with reservoir bag
• insert nasopharyngeal catheter (passed uvula into the pharynx) and give oxygen at flow rates: neonates 0.5 L/min; infants 1 L/min.

FiO2 is determined by flow rate, nasal diameter and body weight: – in infants up to 10 kg: 0.5 L/min (35%); 1 L/min (45%); 2 L/min (55%).

Titrate oxygen to target:

– SpO2 ≥ 90% in adults and children

– SpO2 ≥ 92–95% in pregnant patients

– SpO2 ≥ 94% if child or adult with signs of multi-organ failure, including shock, alteration of mental status, severe anaemia until resuscitation has stabilized patients, then resume target ≥ 90%.

Pressure = (Reistance x Flow) + (Elastance x Vol)

Non-Invasive Ventilation (NIV)

• can be provided via facemask

it has demonstrated high failure rates and lacks recommendations for patients in hypoxemic failure without chronic lung or heart disease. This is a term called de novo respiratory failure.

And for this reason, it is NOT recommended as an approach to avoid intubation in COVID-19 patients.

Optiflow

https://www.fphcare.com/en-gb/hospital/adult-respiratory/optiflow/